Are you feeling overworked? Should your job be split between you and another SLP (or 4)? Here are some tools to present your argument to administrators. Even if you live in a state with no caseload cap, these worksheets will give you an idea of how many hours of direct service, which unfortunately has become the least of our jobs, makes a full-time position by multiplying that number by 1.5 to factor in all the "other" things you have to do.. They are links to other websites for Caseload Worksheets, Workload Calculations, and ASHA's Workload Activity Clusters.

The above site has the Speech Language Caseload Worksheet and Workload Calculation sheet you can download. There are a lot of other useful documents on this site. Many of them apply to North Carolina, but others apply to Speech Pathology in general. Be sure to check out the PowerPoint on SLP's Role in Schools which you can use for an in-service for your teachers.

Why Speech-Language Pathology Services Meet the

Definition of Medical Necessity

Medicaid

There is a lot of discussion regarding Medicaid billing in the schools. One of the key points of debate is how to prove Medical Necessity when we are working to prove Educational Impact. I finally found a document from ASHA that highlights the Medically Necessary piece in a way that makes sense. This is what it says:

Speech-language pathology services are medically necessary to treat speech-language, swallowing, and cognitive-communication disorders. Many of these disorders have a neurological basis such as head injury, Parkinson's disease, stroke, autism, and cerebral palsy.

Determining medical necessity takes into consideration whether a service is essential and appropriate to the diagnosis and/or treatment of an illness, injury, or disease, which Stedman's medical dictionary (2000) defines as an interruption, cessation, or disorder of body function.. Impaired speech and language, loss of hearing, and swallowing difficulties all reflect a loss of body functions and, therefore, services to treat such impairments meet the definition of medical necessity.

Developmental conditions refer to specific impairments that differ from the

normal condition and also meet the definition of medical necessity.

Developmental conditions may be referred to as developmental disorders,

developmental disabilities, and developmental delays.

Stedman's medical dictionary (2000) defines development as the act or process of natural progression in physical and psychological maturation from previous, lower, or embryonic stage to a later, more complex, or adult stage. Development is a natural state, but when paired with disorder, disability, or delay, it indicates an abnormal state.

A diagnosis of developmental impairment in a child indicates an abnormal state of function, and speech-language treatment services are as medically necessary for this patient as they are for an adult who has suffered a stroke and lost speech and language function.

We are NOT required to make them up! Know the law! However, your district can make you meet the minimum you have documented on the IEP. Be sure to account for these sessions by making realistic statements on service time.

EXAMPLE: If you are to see a child once a week and have nine weeks in a reporting period, you can write 7x/per reporting the reporting period. Be sure to have this discussion with your Director to protect both you the district. Stand up for yourself!